Sentinel Node Dissection -- Recovery

I was back to work in a week, but I did do the excercises diligently.

This sounds normal. I had zero pain from the incision on my breast, but my underarm and midway down the back of my arm was very/very/very sore for six months. Apparently, there are millions of nerves in the underarm area, so that small incision packs a punch.  I didn't do the exercises (because my arm hurt) and ended up with frozen shoulder - which was very painful and lasted for six months. It took months of exercises to resolve that.

You should do the exercises and keep your arm moving (to avoid frozen shoulder).  Also, the constant motion will keep the blood flowing, which will help with healing. I don't know how long it will take for you to get full range of motion back, but I had surgery in May 2009 and this past summer (2010), I was playing a mean game of tennis.  It will get better for you too.

PT for LE… yes for lymphedema. Unfortunately I'm doing that now. I have a mild case but in the arm with 10 nodes. Sentinel is OK but I do have some cording.

I think I started PT 3 weeks from my surgery but remember my 10 nodes side was much more limited. My sentinel side was doing better so I don't think I would have been sent as soon if it was just for the sentinel side.

I never got frozen shoulder and my posture has been pretty good throughout.

SLNB can take 1-4 nodes. I had 4 on my SNLB. Cording can show up pretty quickly. A PT can stretch and loosen the incision (that is sticking) that might be causing it. I really don't know a lot about it. You will find a lot of BS don't know much about cording either.

Also when they take out nodes the can take out some fat too. The nodes are sitting in fat tissue so some of it may be gone. That might be why the arms look different. In my case I've had fluid retention in my arms first from surgery then chemo and of course lymphedema on one side. I'm still waiting for my upper arms to become skinny again.

This is all information that you should talk to your doctor about. If s/he isn't giving you answers get a second opinion.

Hi cycle path,

 I had limited arm movement after my mastectomy/SLNB. My BS did not recommend any specific exercises, but did encourage me to use my arm as much as possible for everyday tasks like brushing my hair & teeth, blow drying my hair, getting dressed. I did that as much as possible, even though my instinct was to favor and protect that arm.

I developed cording in my armpit 3-4 weeks after surgery (ouch!). When I next saw my plastic surgeon, I showed him the cording and he showed me how to massage it - basically deep massage to break up forming scar tissue. He said do it twice a day for 3-5 minutes. My cording was 90% better after the first day of massage, and entirely gone within within 2 weeks.

 I don't know whether you need a PT/LE specialist to do this kind of massage -- I didn't, obviously -- but maybe it depends on how severe the cording is?

Sentinel node recovery is definitely glossed over, and what you posted seems normal. All I recall being told by BS and nurse was that although I didn't fill my Tylenol with codeine prescription for my lumpectomy, I'd better have my husband fill it for the SN recovery (I had the SNB 2 weeks after the lumpectomy, when the pathology report stated 1.75 mm of grade 2 IDC appeared along with the grade 2 DCIS), because I'd feel discomfort for the first few days. The lumpectomy recovery was definitely less painful, which did surprise me given the scar area, but I'm not complaining that either one was awful.

However, I'm now 1 year out from my Jan'10 lumpectomy and Jan'10 SNB, and there are times when the underarm SN scar region feels tight and/or sensitive. I don't let it throw me, but it is a little reminder, unlike my lumpectomy which I don't feel any lingering physical discomfort from (the mental discomfort will always be there, although hopefully diminishing over time and healthy annual mammos.)

I saw the title of this thread and just had to vent, even though my problem is different from what you are experiencing.  I had the sentinel node biopsy from hell.  When I went home from surgery I had a lump bigger than a grapefruit under my arm.  A week later, the incision opened up and the wound started bleeding, draining etc.  My surgeon totally blew me off, said there was nothing she could do for me.  After 3 months of being ignored by my surgeon, my primary care physician finally referred me to a wound clinic.  Its now been 5 months and I still have an open wound that needs to be packed twice a day.  I went through chemo with an open wound and now will be starting radiation next week with an open wound in the field of radiation. GRRRRRRR- I'm SOOO angry at my  BS..., and also feeling sorry for myself....

Blindsided, I had the same experience as you.

Including sudden and extensive bleeding on my brand new matress! I am scheduled for further axillary node dissection tomorrow so the surgeon will re-open the wound (I also have a big swelling where my left breast was, B cup size!) and clean it out at the same time. The swelling actually bled through the drain incision, which I thought was completely closed after its been dry for over five days. I am looking forward to days when my arm isn't rubbing against the swelling and when I am not walking around like a body builder with arms away from my body. Although, with additional nodes removed, not sure what to expect next.....

All the best to you!

CTMOM1234:  thanks- that's encouraging, I hope that my beams will avoid the wound area too! 

mks16: Good luck with your surgery tomorrow.  i hope that your problem resolves more quickly than mine has. At least your surgeon is stepping up and dealing with the problem!  I also I felt like a body builder with my arm stuck out to the side!  I also usually had a bag of frozen peas tucked in my arm pit to help with the swelling- a very attractive look!

cycle-path: that's a good idea, I wich I had thought of that when I went for my planning session- I'll have to ask on Monday!

Hi Veronica -

I had my sentinel node biopsy at the same time as my lumpectomy, and I could have done a desk job the second day following surgery if I had needed to - it really only hurt for the first 24 hours, but it also took a while to not feel wonky from the anesthesia. Mine was on the left though, and I'm right-handed so I don't know if that would make a difference. I did (and actually still do) have some pain on extending my arm up over my head, and I did have the cording which caused some discomfort, but it wasn't anything that would actually have kept me from anything but heavy lifting. Typing, moving papers etc. would not have been a problem. That said, if you can get a week off, then go for it, but I can’t see that you would need more than that.

Hope this helps!